Hospital's breast cancer treatment targets cancer, protects the heart
[June 18 2013] -
The Hospital of Central Connecticut (HOCC) is one of few area hospitals offering prone radiation therapy that treats breast cancer confined to the left breast while sparing and protecting the heart from radiation.
While radiation therapy has proven beneficial for some forms of breast cancer, such treatment to the left breast can increase heart disease risk.
That risk is reduced to zero with prone radiation therapy, a technique that emits no radiation to the heart and lungs during treatment and is appropriate for patients with primary left-side cancer, namely cancer that hasn't spread beyond the breast.
"Coronary artery disease typically shows up 10 to 20 years after radiation therapy," says Neal Goldberg, M.D., HOCC's chief of Radiation Oncology. "This is significant because many patients with primary breast cancer are cured and live a normal lifespan."
More than 20 patients have been treated at HOCC using prone radiation therapy since it became available at HOCC in 2010. During treatment a patient lies on the stomach vs. back. Aside from a different table top where the patient lies, prone radiation does not require special equipment. It does require some extra training for radiation therapy team members.
Doctors have known for years that breast cancer patients treated with radiation therapy while lying on their backs are at higher risk for coronary artery disease, Goldberg says.
Results of a study published in the March New England Journal of Medicine were more specific. According to the study, a 50-year-old woman with no cardiovascular risk factors has a 1.9 percent chance of dying of heart disease before age 80. Depending on how much radiation hits the heart, breast cancer radiation treatment increases that risk 2.4 percent to 3.4 percent. Researchers emphasized that the benefits of radiation therapy for breast cancer outweigh the risk of heart disease.
Goldberg agrees, but notes that with the prone technique the risk of heart disease resulting from radiation therapy falls to zero.
"Having the ability to provide effective radiation therapy in the prone position while sparing the heart is a wonderful advance for women with left-sided breast cancer," says cardiologist Heather Swales, M.D., director of the hospital's Women's Heart Wellness Center. Chest radiation treatment, particularly on the left side, she says, can damage lining of blood vessels that supply the heart and to the heart itself, leading to coronary artery disease, which can lead to heart attack.
Swales notes that women who have had radiation therapy to the chest should be particularly attentive to changeable risk factors that lead to coronary artery disease, like high blood pressure, high cholesterol, diabetes and smoking.